Background
Increasing Caesarean Section (CS) rates is a concern in the health care systems all over the world, in a developing country an increase in the CS rate has major implications on the limited health care resources, this study was carried out with an objective to find out the trends and indications of CS in a government hospital.

Method 
A hospital based retrospective study was carried out  in a tertiary Government-run hospital specializing in Obstetrics and Gynaecology and all deliveries conducted from Jan 1st 2009 to Dec 31st 2009 were included, the data was collected using a pro forma designed based on the recommendations for routine reporting on caesarean delivery in developing countries.

Results
There were 7543 deliveries in the study period with 1756 being CS, giving a rate of 23.27%. Most of the CSs were performed because of a previous CS. Foetal distress, breech presentation and failed induction were the other prominent indications. Placenta praevia and malpresentations were the most important absolute Indications of CS.

Conclusion
There has been a steady rise in CS rates in our hospital over the years; major indications were Previous caesarean section, followed by Foetal Distress and Breech presentation. Trial of Vaginal Birth After Caesarean should be given, failing which, a CS has to be performed if indicated.